0001209191-12-036319.txt : 20120702 0001209191-12-036319.hdr.sgml : 20120702 20120702182428 ACCESSION NUMBER: 0001209191-12-036319 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120628 FILED AS OF DATE: 20120702 DATE AS OF CHANGE: 20120702 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SINGER KAREN CENTRAL INDEX KEY: 0001265181 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13117 FILM NUMBER: 12941567 MAIL ADDRESS: STREET 1: 212 VACCARO DRIVE CITY: CRESSKILL STATE: NJ ZIP: 07626 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HealthWarehouse.com, Inc. CENTRAL INDEX KEY: 0000754813 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DRUG STORES AND PROPRIETARY STORES [5912] IRS NUMBER: 222413505 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7107 INDUSTRIAL ROAD CITY: FLORENCE STATE: KY ZIP: 41042 BUSINESS PHONE: (513) 618-0911 MAIL ADDRESS: STREET 1: 7107 INDUSTRIAL ROAD CITY: FLORENCE STATE: KY ZIP: 41042 FORMER COMPANY: FORMER CONFORMED NAME: HealthWarehouse, Inc. DATE OF NAME CHANGE: 20090818 FORMER COMPANY: FORMER CONFORMED NAME: CLACENDIX, INC. DATE OF NAME CHANGE: 20080107 FORMER COMPANY: FORMER CONFORMED NAME: ION NETWORKS INC DATE OF NAME CHANGE: 19990413 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2012-06-28 0 0000754813 HealthWarehouse.com, Inc. HEWA 0001265181 SINGER KAREN 212 VACCARO DRIVE CRESSKILL NJ 07626 0 0 1 0 Common Stock 2012-06-28 4 X 0 156250 1.60 A 156250 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Common Stock 2012-06-28 4 X 0 156250 1.60 A 312500 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Common Stock 2012-06-28 4 X 0 585808 3.00 A 898308 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Common Stock 2012-06-28 4 X 0 250000 2.90 A 1148303 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Common Stock 2012-06-28 4 S 0 38343 6.74 D 1109965 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Common Stock 2012-06-28 4 S 0 38343 6.74 D 1071622 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Common Stock 2012-06-28 4 S 0 251419 6.99 D 820203 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Common Stock 2012-06-28 4 S 0 103719 6.99 D 716484 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Warrant 2.90 2012-06-28 2012-06-28 4 X 0 250000 0.00 D 2011-09-02 2016-09-02 Common Stock 250000 0 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Warrant 1.60 2012-06-28 2012-06-28 4 X 0 156250 0.00 D 2009-12-15 2014-12-15 Common Stock 156250 0 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Warrant 1.60 2012-06-28 2012-06-28 4 X 0 156250 0.00 D 2010-05-03 2015-05-03 Common Stock 156250 0 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Series B Preferred Stock 0.00 2010-11-08 Common Stock 886895 886895 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC 7% Senior Secured Convertible Promissory Note 0.00 2010-11-08 2012-12-31 Common Stock 292620 292620 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC Warrant 3.00 2012-06-28 2012-06-28 4 X 0 585808 0.00 D 2010-11-08 2015-11-08 Common Stock 585808 0 I As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC The reporting person disclaims beneficial ownership of these securities except to the extent of her pecuniary interest therein. This filing shall not be deemed an admission that the reporting person is, for purposes of Section 16 of the Act or otherwise, the beneficial owner of any equity securities covered by this filing. The reporting person exercised a warrant to purchase 156,250 shares of common stock for the original conversion price of $1.60 per share. The reporting person paid the exercise price on a cashless basis, resulting in the company issuing 117,907 shares of common stock to the reporting person. The reporting person exercised a warrant to purchase 585,808 shares of common stock for the original conversion price of $3.00 per share. The reporting person paid the exercise price on a cashless basis, resulting in the company issuing 334,389 shares of common stock to the reporting person. The reporting person exercised a warrant to purchase 250,000 shares of common stock for the original conversion price of $2.90 per share. The reporting person paid the exercise price on a cashless basis, resulting in the company issuing 146,281 shares of common stock to the reporting person. The reporting person holds 177,379 shares of Series B Preferred Stock. This amount includes 11,605 shares of Series B Preferred Stock received by the reporting person as a dividend for the year 2011. Each share of Series B Preferred Stock is immediately convertible into 5 shares of common stock. N/A The convertible note is immediately convertible into 58,524 shares of Series B Preferred Stock which amount includes a $53,048.39 interest payment on the convertible note received through May 8, 2012. Each share of Series B Preferred Stock is immediately convertible into 5 shares of common stock. /s/ David J. Hoyt Attorney-in-fact 2012-07-02